PROJECT SUMMARY Barbara K. Giambra, PhD, RN, CPNP is a pediatric nurse whose overarching career goal is to improve the wellbeing of children who are technology dependent by improving family management of their child?s chronic condition at home, in alignment with the National Institute of Nursing?s mission for improving the quality of life for individuals with chronic illness through self-management. Children who depend on technology such as long-term mechanical ventilation (LTVD) for survival are living longer due to medical advances. Family management involves incorporation of the LTVD child?s complex care into everyday family life. Effective communication between parents and nurses about the home care of the hospitalized child with LTVD is critical to ensure family understanding and management of the child?s care and child wellbeing after discharge. Candidate: Dr. Giambra is an Assistant Professor in the Division of Nursing at Cincinnati Children?s Hospital Medical Center (CCHMC). As a pediatric nurse practitioner, she specialized in the care of children dependent on tracheostomies and ventilators. The proposed K23 career development plan will build upon her clinical career, doctoral work and fellowship training to address areas in which she requires additional development to enhance her ability to become an independent investigator: 1) communication research methods, 2) family research methods and 3) advanced quantitative research design, implementation and analysis skills. The proposed training will provide Dr. Giambra with the necessary skill and expertise to conduct quantitative studies leading to interventional work in future R-level proposals. Mentors/Environment: Dr. Giambra has assembled a mentorship team with research expertise in the care of chronically ill children, family management, healthcare communication and quantitative study design and analysis. The proposed career development plan uses the extensive resources available at CCHMC and the University of Cincinnati, and nationally recognized workshops to complement local training. CCHMC is committed to beginning researchers, providing extensive support including opportunities for education and networking, software, biostatistical advisors, and research, data, and grant management support. Research: The proposed research will begin to fill the gap in knowledge about ways to enhance family management of children with LTVD to improve the child?s wellbeing. Aim 1 will identify and quantify key modifiable parent-nurse communication behaviors used to communicate about the hospitalized LTVD child?s care. Aim 2 will determine which communication behaviors predict parental understanding and home management of the child?s care. Aim 3 will determine the independent effects of parent-nurse communication on the child?s health related quality of life and clinical outcomes after discharge to home. This research will result in a broad understanding of the modifiable parent-nurse communication behaviors used during hospitalization that affect family understanding and management of the child?s home care and child wellbeing.